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REQUEST FOR EXTENDED SERVICE (RES) SUBMIT BEFORE FOURTH VISIT TO: Authorization Services Alameda County Behavioral Health Care Services 2000 Embarcadero Cove, Suite 400 Oakland, CA 94606 Phone (510)
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How to fill out a request for extended service:

01
Start by clearly stating your need for extended service in the opening of the request form. Be specific about the type of service you require and the reasons behind it.
02
Provide your personal details, such as your full name, contact information, and any account or customer numbers that may be relevant.
03
Include the relevant dates, such as the date the service is set to expire and the date you would like the extended service to start or end.
04
Clearly outline any additional details or instructions that may be necessary for the service provider to understand your request. This could include any specific requirements or preferences, such as a specific technician or equipment needed.
05
Attach any supporting documents or evidence that may be necessary to support your request. This could include previous service contracts, invoices, or any other relevant documentation.
06
Review the request form carefully before submitting to ensure that all the information provided is accurate and complete.

Who needs a request for extended service?

01
Individuals or businesses who require ongoing or extended service beyond the specified duration of their initial service agreement.
02
Customers who have encountered unforeseen circumstances or changes in their service needs, requiring an extension of the service period.
03
Clients who want to ensure uninterrupted service or coverage beyond the agreed-upon timeframe.
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Request for extended service is a formal application to prolong the duration of a specific service or agreement beyond its original term.
The party requesting the extension of service is typically required to file the request for extended service.
To fill out a request for extended service, one must provide all required information and justification for the extension.
The purpose of a request for extended service is to formally request additional time for a service or agreement.
The request for extended service must include details about the original service or agreement, reasons for extension, and proposed new end date.
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